Perepletchikova Francheska, Treat Teresa A, Kazdin Alan E
Department of Psychology, Yale University, USA.
J Consult Clin Psychol. 2007 Dec;75(6):829-41. doi: 10.1037/0022-006X.75.6.829.
Treatment integrity refers to the degree to which an intervention is delivered as intended. Two studies evaluated the adequacy of treatment integrity procedures (including establishing, assessing, evaluating, and reporting integrity; therapist treatment adherence; and therapist competence) implemented in psychotherapy research, as well as predictors of their implementation. Randomized controlled trials of psychosocial interventions published in 6 influential psychological and psychiatric journals were reviewed and coded for treatment integrity implementation. Results indicate that investigations that systematically addressed treatment integrity procedures are virtually absent in the literature. Treatment integrity was adequately addressed for only 3.50% of the evaluated psychosocial interventions. Journal of publication and treatment approach predicted integrity implementation. Skill-building treatments (e.g., cognitive-behavioral) as compared with non-skill-building interventions (e.g., psychodynamic, nondirective counseling) were implemented with higher attention to integrity procedures. Guidelines for implementation of treatment integrity procedures need to be reevaluated.
治疗完整性是指干预措施按预期实施的程度。两项研究评估了心理治疗研究中所实施的治疗完整性程序（包括建立、评估、评价和报告完整性；治疗师对治疗的依从性；以及治疗师的能力）的充分性，以及这些程序实施的预测因素。对发表在6种有影响力的心理学和精神病学杂志上的心理社会干预随机对照试验进行了综述，并对治疗完整性的实施情况进行了编码。结果表明，文献中几乎没有系统探讨治疗完整性程序的研究。在评估的心理社会干预中，只有3.50%充分涉及了治疗完整性。发表期刊和治疗方法可预测完整性的实施情况。与非技能培养干预措施（如心理动力学、非指导性咨询）相比，技能培养治疗（如认知行为疗法）在实施时对完整性程序的关注更高。治疗完整性程序的实施指南需要重新评估。
